U.S. patent application number 15/967761 was filed with the patent office on 2018-11-22 for combination ultrasonic and electrosurgical system having generator filter circuitry.
The applicant listed for this patent is ETHICON LLC. Invention is credited to Stephen M. Leuck, Eitan T. Wiener.
Application Number | 20180333184 15/967761 |
Document ID | / |
Family ID | 62620977 |
Filed Date | 2018-11-22 |
United States Patent
Application |
20180333184 |
Kind Code |
A1 |
Leuck; Stephen M. ; et
al. |
November 22, 2018 |
COMBINATION ULTRASONIC AND ELECTROSURGICAL SYSTEM HAVING GENERATOR
FILTER CIRCUITRY
Abstract
A surgical system includes a surgical instrument having a body,
a shaft extending distally from the body, an ultrasonic transducer
supported by the body, and an end effector at a distal end of the
shaft. The end effector includes an ultrasonic blade configured to
be driven by the ultrasonic transducer with ultrasonic energy, and
an RF electrode operable to seal tissue with RF energy. A generator
is operatively coupled with the surgical instrument and is operable
to generate a combined drive signal having an ultrasonic energy
component and an RF energy component. Filter circuitry arranged
externally of the body of the surgical instrument is operable to
convert the combined drive signal to an ultrasonic drive signal
configured to energize the ultrasonic transducer to drive the
ultrasonic blade with ultrasonic energy, and an RF drive signal
configured to energize the RF electrode with RF energy sufficient
to seal tissue.
Inventors: |
Leuck; Stephen M.; (Milford,
OH) ; Wiener; Eitan T.; (Cincinnati, OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
ETHICON LLC |
Guaynabo |
PR |
US |
|
|
Family ID: |
62620977 |
Appl. No.: |
15/967761 |
Filed: |
May 1, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62509351 |
May 22, 2017 |
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2018/00077
20130101; A61B 2017/2932 20130101; A61B 2018/00136 20130101; A61B
2018/00083 20130101; A61B 2018/1452 20130101; A61B 17/320092
20130101; A61B 18/1206 20130101; A61B 2018/00178 20130101; A61B
2017/320075 20170801; A61B 18/00 20130101; A61B 2017/00929
20130101; A61B 2017/320074 20170801; A61B 2018/00607 20130101; A61B
18/1445 20130101; A61B 2018/0063 20130101; A61B 2017/320094
20170801; A61B 17/320068 20130101; A61B 2017/2929 20130101; A61B
2017/00017 20130101; A61B 2017/320088 20130101; A61B 2018/00577
20130101; A61B 2017/00738 20130101; A61B 2017/320072 20130101; A61B
2018/00988 20130101; A61B 2018/126 20130101; A61B 2018/142
20130101; A61B 2090/0803 20160201; A61B 2017/00137 20130101; A61B
2017/320078 20170801; A61B 2017/320095 20170801; A61B 2018/00994
20130101; A61B 2018/1457 20130101 |
International
Class: |
A61B 18/00 20060101
A61B018/00; A61B 18/12 20060101 A61B018/12; A61B 18/14 20060101
A61B018/14 |
Claims
1. A surgical system comprising: (a) a surgical instrument,
comprising: (i) a body, (ii) a shaft extending distally from the
body, (iii) an ultrasonic transducer supported by the body, and
(iv) an end effector arranged at a distal end of the shaft, wherein
the end effector comprises: (A) an ultrasonic blade, wherein the
ultrasonic transducer is operable to drive the ultrasonic blade
with ultrasonic energy, and (B) an RF electrode operable to seal
tissue with RF energy; (b) a generator operatively coupled with the
surgical instrument, wherein the generator is operable to generate
a combined drive signal having an ultrasonic energy component and
an RF energy component; and (c) filter circuitry arranged
externally of the body of the surgical instrument, wherein the
filter circuitry is operable to convert the combined drive signal
to: (i) an ultrasonic drive signal configured to energize the
ultrasonic transducer to drive the ultrasonic blade with ultrasonic
energy, and (ii) an RF drive signal configured to energize the RF
electrode with RF energy sufficient to seal tissue.
2. The surgical system of claim 1, further comprising: (a) a power
cable configured to couple to the surgical instrument; and (b) a
cable adapter configured to couple the power cable with the
generator, wherein the filter circuitry is arranged within one of
the power cable or the cable adapter.
3. The surgical system of claim 2, wherein the power cable is
configured to releasably couple to the cable adapter.
4. The surgical system of claim 2, wherein the filter circuitry is
arranged within the cable adapter.
5. The surgical system of claim 2, wherein the filter circuitry is
arranged within the power cable.
6. The surgical system of claim 1, wherein the filter circuitry is
integrated with the generator.
7. The surgical system of claim 1, wherein a distal end of the
power cable is configured to releasably couple with the body.
8. The surgical system of claim 1, wherein a distal end of the
power cable is configured to couple with a proximal end of the
body.
9. The surgical system of claim 8, wherein the distal end of the
cable is configured to align coaxially with the ultrasonic
transducer when the power cable is coupled with the body.
10. The surgical system of claim 1, wherein the ultrasonic
transducer is housed within an interior of the body.
11. The surgical system of claim 1, wherein the ultrasonic
transducer is supported externally of the body.
12. The surgical system of claim 11, wherein the filter circuitry
is integrated with the ultrasonic transducer.
13. The surgical system of claim 1, wherein the RF electrode is
provided by the ultrasonic blade.
14. The surgical system of claim 1, wherein the RF electrode
comprises a first RF electrode, wherein the RF drive signal is
configured to energize the first and second RF electrodes with
bipolar RF energy sufficient to seal tissue.
15. The surgical system of claim 14, wherein the end effector
further comprises a clamp arm, wherein the clamp arm provides the
first RF electrode and the ultrasonic blade provides the second RF
electrode.
16. A surgical system comprising: (a) a surgical instrument,
comprising: (i) an ultrasonic transducer, (ii) a shaft extending
distally relative to the ultrasonic transducer, and (iii) an end
effector arranged at a distal end of the shaft, wherein the end
effector comprises: (A) an ultrasonic blade, wherein the ultrasonic
transducer is operable to drive the ultrasonic blade with
ultrasonic energy, and (B) an RF electrode operable to seal tissue
with RF energy; (b) a generator operatively coupled with the
surgical instrument, wherein the generator is operable to generate
a combined drive signal having an ultrasonic energy component and
an RF energy component; and (c) an accessory device configured to
operatively couple the generator with the surgical instrument,
wherein the accessory device includes filter circuitry operable to
convert the combined drive signal to: (i) an ultrasonic drive
signal configured to energize the ultrasonic transducer to drive
the ultrasonic blade with ultrasonic energy, and (ii) an RF drive
signal configured to energize the RF electrode with RF energy
sufficient to seal tissue.
17. The surgical system of claim 16, wherein the accessory device
is arranged externally of the surgical instrument and the
generator.
18. The surgical system of claim 16, wherein the accessory device
comprises one of a power cable configured to couple to the surgical
instrument or a cable adapter configured to couple the power cable
to the generator.
19. A method of delivering energy to a surgical instrument having
an ultrasonic blade and an RF electrode, the method comprising: (a)
generating a combined drive signal with a generator, wherein the
combined drive signal includes an ultrasonic energy component and
an RF energy component; (b) receiving the combined drive signal
with an accessory device that communicates with the generator and
with the surgical instrument, wherein the accessory device includes
filter circuitry; (c) filtering the combined drive signal with the
filter circuitry to produce an ultrasonic drive signal and a
separate RF drive signal; (d) transmitting the ultrasonic drive
signal and the RF drive signal from the accessory device to the
surgical instrument so that: (i) the ultrasonic drive signal
energizes an ultrasonic transducer to drive the ultrasonic blade
with ultrasonic energy, and (ii) the RF drive signal energizes the
RF electrode with RF energy sufficient to seal tissue.
20. The method of claim 19, wherein the accessory device comprises
at least one of a power cable or a cable adapter.
Description
[0001] This application claims the benefit of U.S. Provisional App.
No. 62/509,351, entitled "Ultrasonic Instrument With
Electrosurgical Features," filed May 22, 2017, the disclosure of
which is incorporated by reference herein.
BACKGROUND
[0002] Ultrasonic surgical instruments utilize ultrasonic energy
for both precise cutting and controlled coagulation of tissue. The
ultrasonic energy cuts and coagulates by vibrating a blade in
contact with the tissue. Vibrating at frequencies of approximately
50 kilohertz (kHz), for example, the ultrasonic blade denatures
protein in the tissue to form a sticky coagulum. Pressure exerted
on the tissue with the blade surface collapses blood vessels and
allows the coagulum to form a hemostatic seal. The precision of
cutting and coagulation may be controlled by the surgeon's
technique and adjusting the power level, blade edge, tissue
traction, and blade pressure, for example.
[0003] Examples of ultrasonic surgical devices include the HARMONIC
ACE.RTM. Ultrasonic Shears, the HARMONIC WAVE.RTM. Ultrasonic
Shears, the HARMONIC FOCUS.RTM. Ultrasonic Shears, and the HARMONIC
SYNERGY.RTM. Ultrasonic Blades, all by Ethicon Endo-Surgery, Inc.
of Cincinnati, Ohio. Further examples of such devices and related
concepts are disclosed in U.S. Pat. No. 5,322,055, entitled "Clamp
Coagulator/Cutting System for Ultrasonic Surgical Instruments,"
issued Jun. 21, 1994, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 5,873,873, entitled "Ultrasonic
Clamp Coagulator Apparatus Having Improved Clamp Mechanism," issued
Feb. 23, 1999, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 5,980,510, entitled "Ultrasonic Clamp
Coagulator Apparatus Having Improved Clamp Arm Pivot Mount," issued
Nov. 9, 1999, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 6,283,981, entitled "Method of Balancing
Asymmetric Ultrasonic Surgical Blades," issued Sep. 4, 2001, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 6,309,400, entitled "Curved Ultrasonic Blade having a
Trapezoidal Cross Section," issued Oct. 30, 2001, the disclosure of
which is incorporated by reference herein; U.S. Pat. No. 6,325,811,
entitled "Blades with Functional Balance Asymmetries for use with
Ultrasonic Surgical Instruments," issued Dec. 4, 2001, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 6,423,082, entitled "Ultrasonic Surgical Blade with Improved
Cutting and Coagulation Features," issued Jul. 23, 2002, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 6,773,444, entitled "Blades with Functional Balance Asymmetries
for Use with Ultrasonic Surgical Instruments," issued Aug. 10,
2004, the disclosure of which is incorporated by reference herein;
U.S. Pat. No. 6,783,524, entitled "Robotic Surgical Tool with
Ultrasound Cauterizing and Cutting Instrument," issued Aug. 31,
2004, the disclosure of which is incorporated by reference herein;
U.S. Pat. No. 8,057,498, entitled "Ultrasonic Surgical Instrument
Blades," issued Nov. 15, 2011, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 8,461,744, entitled
"Rotating Transducer Mount for Ultrasonic Surgical Instruments,"
issued Jun. 11, 2013, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 8,591,536, entitled "Ultrasonic
Surgical Instrument Blades," issued Nov. 26, 2013, the disclosure
of which is incorporated by reference herein; U.S. Pat. No.
8,623,027, entitled "Ergonomic Surgical Instruments," issued Jan.
7, 2014, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 9,095,367, entitled "Flexible Harmonic
Waveguides/Blades for Surgical Instruments," issued Aug. 4, 2015,
the disclosure of which is incorporated by reference herein; and
U.S. Pub. No. 2016/0022305, entitled "Ultrasonic Blade Overmold,"
published Jan. 28, 2016, the disclosure of which is incorporated by
reference herein.
[0004] Electrosurgical instruments utilize electrical energy for
sealing tissue, and generally include a distally mounted end
effector that can be configured for bipolar or monopolar operation.
During bipolar operation, electrical current is provided through
the tissue by active and return electrodes of the end effector.
During monopolar operation, current is provided through the tissue
by an active electrode of the end effector and a return electrode
(e.g., a grounding pad) separately located on a patient's body.
Heat generated by the current flowing through the tissue may form
hemostatic seals within the tissue and/or between tissues, and thus
may be particularly useful for sealing blood vessels, for example.
The end effector of an electrosurgical device may also include a
cutting member that is movable relative to the tissue and the
electrodes to transect the tissue.
[0005] Electrical energy applied by an electrosurgical device can
be transmitted to the instrument by a generator coupled with the
instrument. The electrical energy may be in the form of radio
frequency ("RF") energy, which is a form of electrical energy
generally in the frequency range of approximately 300 kilohertz
(kHz) to 1 megahertz (MHz). In use, an electrosurgical device can
transmit lower frequency RF energy through tissue, which causes
ionic agitation, or friction, in effect resistive heating, thereby
increasing the temperature of the tissue. Because a sharp boundary
is created between the affected tissue and the surrounding tissue,
surgeons can operate with a high level of precision and control,
without sacrificing un-targeted adjacent tissue. The low operating
temperatures of RF energy may be useful for removing, shrinking, or
sculpting soft tissue while simultaneously sealing blood vessels.
RF energy works particularly well on connective tissue, which is
primarily comprised of collagen and shrinks when contacted by
heat.
[0006] An example of an RF electrosurgical device is the
ENSEAL.RTM. Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of
Cincinnati, Ohio. Further examples of electrosurgical devices and
related concepts are disclosed in U.S. Pat. No. 6,500,176 entitled
"Electrosurgical Systems and Techniques for Sealing Tissue," issued
Dec. 31, 2002, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 7,112,201 entitled "Electrosurgical
Instrument and Method of Use," issued Sep. 26, 2006, the disclosure
of which is incorporated by reference herein; U.S. Pat. No.
7,125,409, entitled "Electrosurgical Working End for Controlled
Energy Delivery," issued Oct. 24, 2006, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 7,169,146 entitled
"Electrosurgical Probe and Method of Use," issued Jan. 30, 2007,
the disclosure of which is incorporated by reference herein; U.S.
Pat. No. 7,186,253, entitled "Electrosurgical Jaw Structure for
Controlled Energy Delivery," issued Mar. 6, 2007, the disclosure of
which is incorporated by reference herein; U.S. Pat. No. 7,189,233,
entitled "Electrosurgical Instrument," issued Mar. 13, 2007, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 7,220,951, entitled "Surgical Sealing Surfaces and Methods of
Use," issued May 22, 2007, the disclosure of which is incorporated
by reference herein; U.S. Pat. No. 7,309,849, entitled "Polymer
Compositions Exhibiting a PTC Property and Methods of Fabrication,"
issued Dec. 18, 2007, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 7,311,709, entitled
"Electrosurgical Instrument and Method of Use," issued Dec. 25,
2007, the disclosure of which is incorporated by reference herein;
U.S. Pat. No. 7,354,440, entitled "Electrosurgical Instrument and
Method of Use," issued Apr. 8, 2008, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 7,381,209, entitled
"Electrosurgical Instrument," issued Jun. 3, 2008, the disclosure
of which is incorporated by reference herein.
[0007] Additional examples of electrosurgical devices and related
concepts are disclosed in U.S. Pat. No. 8,939,974, entitled
"Surgical Instrument Comprising First and Second Drive Systems
Actuatable by a Common Trigger Mechanism," issued Jan. 27, 2015,
the disclosure of which is incorporated by reference herein; U.S.
Pat. No. 9,161,803, entitled "Motor Driven Electrosurgical Device
with Mechanical and Electrical Feedback," issued Oct. 20, 2015, the
disclosure of which is incorporated by reference herein; U.S. Pub.
No. 2012/0078243, entitled "Control Features for Articulating
Surgical Device," published Mar. 29, 2012, the disclosure of which
is incorporated by reference herein; U.S. Pat. No. 9,402,682,
entitled "Articulation Joint Features for Articulating Surgical
Device," issued Aug. 2, 2016, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 9,089,327, entitled
"Surgical Instrument with Multi-Phase Trigger Bias," issued Jul.
28, 2015, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 9,545,253, entitled "Surgical Instrument with
Contained Dual Helix Actuator Assembly," issued Jan. 17, 2017, the
disclosure of which is incorporated by reference herein; and U.S.
Pat. No. 9,572,622, entitled "Bipolar Electrosurgical Features for
Targeted Hemostasis," issued Feb. 21, 2017, the disclosure of which
is incorporated by reference herein.
[0008] Some instruments may provide ultrasonic and RF energy
treatment capabilities through a single surgical device. Examples
of such devices and related methods and concepts are disclosed in
U.S. Pat. No. 8,663,220, entitled "Ultrasonic Surgical
Instruments," issued Mar. 4, 2014, the disclosure of which is
incorporated by reference herein; U.S. Pub. No. 2015/0141981,
entitled "Ultrasonic Surgical Instrument with Electrosurgical
Feature," published May 21, 2015, the disclosure of which is
incorporated by reference herein; and U.S. Pub. No. 2017/0000541,
entitled "Surgical Instrument with User Adaptable Techniques,"
published Jan. 5, 2017, the disclosure of which is incorporated by
reference herein.
[0009] While various types of ultrasonic surgical instruments and
electrosurgical instruments, including combination
ultrasonic-electrosurgical instruments, have been made and used, it
is believed that no one prior to the inventor(s) has made or used
the invention described in the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] The accompanying drawings, which are incorporated in and
constitute a part of this specification, illustrate embodiments of
the invention, and, together with the general description of the
invention given above, and the detailed description of the
embodiments given below, serve to explain the principles of the
present invention.
[0011] FIG. 1 depicts a perspective view of an exemplary surgical
system having a generator and a surgical instrument operable to
treat tissue with ultrasonic energy and bipolar RF energy;
[0012] FIG. 2 depicts a top perspective view of an end effector of
the surgical instrument of FIG. 1, having a clamp arm that provides
a first electrode and an ultrasonic blade that provides a second
electrode;
[0013] FIG. 3 depicts a bottom perspective view of the end effector
of FIG. 2;
[0014] FIG. 4 depicts a partially exploded perspective view of the
surgical instrument of FIG. 1;
[0015] FIG. 5 depicts an enlarged exploded perspective view of a
distal portion of the shaft assembly and the end effector of the
surgical instrument of FIG. 1;
[0016] FIG. 6 depicts a side elevational view of a distal portion
of an inner tube of the shaft assembly of the surgical instrument
of FIG. 1;
[0017] FIG. 7 depicts a partially schematic view of an exemplary
surgical system incorporating the surgical instrument of FIG. 1
having an internally mounted ultrasonic transducer, an exemplary
power cable, an adapter, and a generator;
[0018] FIG. 8 depicts a partially schematic view of another
exemplary surgical system incorporating a surgical instrument
having an externally mounted ultrasonic transducer, a power cable,
an adapter, and a generator;
[0019] FIG. 9 depicts a schematic view of an exemplary surgical
system including a surgical instrument, filter circuitry, and a
generator;
[0020] FIG. 10 depicts a schematic view of an exemplary version of
the surgical system of FIG. 9, in which the filter circuitry is
arranged within an accessory of the surgical system;
[0021] FIG. 11 depicts a schematic view of another exemplary
version of the surgical system of FIG. 9, in which the filter
circuitry is arranged within the generator of the surgical
system;
[0022] FIG. 12 depicts a schematic view of another exemplary
version of the surgical system of FIG. 9, in which the filter
circuitry is arranged within the surgical instrument of the
surgical system;
[0023] FIG. 13 depicts a side elevational view of the surgical
instrument of FIG. 7 with a side body portion of the handle
assembly omitted, the surgical instrument including filter
circuitry according to the exemplary system configuration of FIG.
12, the filter circuitry schematically shown arranged at several
optional locations within the handle assembly; and
[0024] FIG. 14 depicts a side elevational view of the surgical
instrument of FIG. 8, the surgical instrument including filter
circuitry according to the exemplary system configuration of FIG.
12, the filter circuitry schematically shown arranged within the
externally mounted ultrasonic transducer.
[0025] The drawings are not intended to be limiting in any way, and
it is contemplated that various embodiments of the invention may be
carried out in a variety of other ways, including those not
necessarily depicted in the drawings. The accompanying drawings
incorporated in and forming a part of the specification illustrate
several aspects of the present invention, and together with the
description serve to explain the principles of the invention; it
being understood, however, that this invention is not limited to
the precise arrangements shown.
DETAILED DESCRIPTION
[0026] The following description of certain examples of the
invention should not be used to limit the scope of the present
invention. Other examples, features, aspects, embodiments, and
advantages of the invention will become apparent to those skilled
in the art from the following description, which is by way of
illustration, one of the best modes contemplated for carrying out
the invention. As will be realized, the invention is capable of
other different and obvious aspects, all without departing from the
invention. Accordingly, the drawings and descriptions should be
regarded as illustrative in nature and not restrictive.
[0027] For clarity of disclosure, the terms "proximal" and "distal"
are defined herein relative to a surgeon, or other operator,
grasping a surgical instrument having a distal surgical end
effector. The term "proximal" refers to the position of an element
arranged closer to the surgeon, and the term "distal" refers to the
position of an element arranged closer to the surgical end effector
of the surgical instrument and further away from the surgeon.
Moreover, to the extent that spatial terms such as "upper,"
"lower," "vertical," "horizontal," or the like are used herein with
reference to the drawings, it will be appreciated that such terms
are used for exemplary description purposes only and are not
intended to be limiting or absolute. In that regard, it will be
understood that surgical instruments such as those disclosed herein
may be used in a variety of orientations and positions not limited
to those shown and described herein.
[0028] I. Exemplary Surgical System Having Surgical Instrument with
Ultrasonic and Electrosurgical Features
[0029] FIG. 1 depicts an exemplary surgical system (10) including a
generator (12) and a surgical instrument (14). Surgical instrument
(14) is operatively coupled with the generator (12) via power cable
(16). As described in greater detail below, generator (12) is
operable to power surgical instrument (14) to deliver ultrasonic
energy for cutting tissue, and electrosurgical bipolar RF energy
(i.e., therapeutic levels of RF energy) for sealing tissue. In
exemplary configurations, generator (12) is configured to power
surgical instrument (14) to deliver ultrasonic energy and
electrosurgical bipolar RF energy simultaneously.
[0030] Surgical instrument (14) of the present example comprises a
handle assembly (18), a shaft assembly (20) extending distally from
the handle assembly (18), and an end effector (22) arranged at a
distal end of the shaft assembly (20). Handle assembly (18)
comprises a body (24) including a pistol grip (26) and energy
control buttons (28, 30) configured to be manipulated by a surgeon.
A trigger (32) is coupled to a lower portion of body (24) and is
pivotable toward and away from pistol grip (26) to selectively
actuate end effector (22), as described in greater detail below. In
other suitable variations of surgical instrument (14), handle
assembly (18) may comprise a scissor grip configuration, for
example. As described in greater detail below, an ultrasonic
transducer (34) is housed internally within and supported by body
(24). In other configurations, ultrasonic transducer (34) may be
provided externally of body (24) for example as shown in the
exemplary configuration of FIG. 14.
[0031] As shown in FIGS. 2 and 3, end effector (22) includes an
ultrasonic blade (36) and a clamp arm (38) configured to
selectively pivot toward and away from ultrasonic blade (36), for
clamping tissue therebetween. Ultrasonic blade (36) is acoustically
coupled with ultrasonic transducer (34), which is configured to
drive (i.e., vibrate) ultrasonic blade (36) at ultrasonic
frequencies for cutting and/or sealing tissue positioned in contact
with ultrasonic blade (36). Clamp arm (38) is operatively coupled
with trigger (32) such that clamp arm (38) is configured to pivot
toward ultrasonic blade (36), to a closed position, in response to
pivoting of trigger (32) toward pistol grip (26). Further, clamp
arm (38) is configured to pivot away from ultrasonic blade (36), to
an open position (see e.g., FIGS. 1-3), in response to pivoting of
trigger (32) away from pistol grip (26). Various suitable ways in
which clamp arm (38) may be coupled with trigger (32) will be
apparent to those of ordinary skill in the art in view of the
teachings provided herein. In some versions, one or more resilient
members may be incorporated to bias clamp arm (38) and/or trigger
(32) toward the open position.
[0032] A clamp pad (40) is secured to and extends distally along a
clamping side of clamp arm (38), facing ultrasonic blade (36).
Clamp pad (40) is configured to engage and clamp tissue against a
corresponding tissue treatment portion of ultrasonic blade (36)
when clamp arm (38) is actuated to its closed position. At least a
clamping-side of clamp arm (38) provides a first electrode (42),
referred to herein as clamp arm electrode (42). Additionally, at
least a clamping-side of ultrasonic blade (36) provides a second
electrode (44), referred to herein as a blade electrode (44). As
described in greater detail below, electrodes (42, 44) are
configured to apply electrosurgical bipolar RF energy, provided by
generator (12), to tissue electrically coupled with electrodes (42,
44). Clamp arm electrode (42) may serve as an active electrode
while blade electrode (44) serves as a return electrode, or
vice-versa. Surgical instrument (14) may be configured to apply the
electrosurgical bipolar RF energy through electrodes (42, 44) while
vibrating ultrasonic blade (36) at an ultrasonic frequency, before
vibrating ultrasonic blade (36) at an ultrasonic frequency, and/or
after vibrating ultrasonic blade (36) at an ultrasonic
frequency.
[0033] As shown in FIGS. 1-5, shaft assembly (20) extends along a
longitudinal axis and includes an outer tube (46), an inner tube
(48) received within outer tube (46), and an ultrasonic waveguide
(50) supported within inner tube (48). As seen best in FIGS. 2-5,
clamp arm (38) is coupled to distal ends of inner and outer tubes
(46, 48). In particular, clamp arm (38) includes a pair of
proximally extending clevis arms (52) that receive therebetween and
pivotably couple to a distal end (54) of inner tube (48) with a
pivot pin (56) received within through bores formed in clevis arms
(52) and distal end (54) of inner tube (48). First and second
clevis fingers (58) depend downwardly from clevis arms (52) and
pivotably couple to a distal end (60) of outer tube (46).
Specifically, each clevis finger (58) includes a protrusion (62)
that is rotatably received within a corresponding opening (64)
formed in a sidewall of distal end (60) of outer tube (46).
[0034] In the present example, inner tube (48) is longitudinally
fixed relative to handle assembly (18), and outer tube (46) is
configured to translate relative to inner tube (48) and handle
assembly (18), along the longitudinal axis of shaft assembly (20).
As outer tube (46) translates distally, clamp arm (38) pivots about
pivot pin (56) toward its open position. As outer tube (46)
translates proximally, clamp arm (38) pivots in an opposite
direction toward its closed position. A proximal end of outer tube
(46) is operatively coupled with trigger (32), for example via a
linkage assembly, such that actuation of trigger (32) causes
translation of outer tube (46) relative to inner tube (48), thereby
opening or closing clamp arm (38). In other suitable configurations
not shown herein, outer tube (46) may be longitudinally fixed and
inner tube (48) may be configured to translate for moving clamp arm
(38) between its open and closed positions.
[0035] Shaft assembly (20) and end effector (22) are configured to
rotate together about the longitudinal axis, relative to handle
assembly (18). A retaining pin (66), shown in FIG. 4, extends
transversely through proximal portions of outer tube (46), inner
tube (48), and waveguide (50) to thereby couple these components
rotationally relative to one another. In the present example, a
rotation knob (68) is provided at a proximal end portion of shaft
assembly (20) to facilitate rotation of shaft assembly (20), and
end effector (22), relative to handle assembly (18). Rotation knob
(68) is secured rotationally to shaft assembly (20) with retaining
pin (66), which extends through a proximal collar of rotation knob
(68). It will be appreciated that in other suitable configurations,
rotation knob (68) may be omitted or substituted with alternative
rotational actuation structures.
[0036] Ultrasonic waveguide (50) is acoustically coupled at its
proximal end with ultrasonic transducer (34), for example by a
threaded connection, and at its distal end with ultrasonic blade
(36), as shown in FIG. 5. Ultrasonic blade (36) is shown formed
integrally with waveguide (50) such that blade (36) extends
distally, directly from the distal end of waveguide (50). In this
manner, waveguide (50) acoustically couples ultrasonic transducer
(34) with ultrasonic blade (36), and functions to communicate
ultrasonic mechanical vibrations from transducer (34) to blade
(36). Accordingly, ultrasonic transducer (34), waveguide (50), and
ultrasonic blade (36) together define acoustic assembly (100).
During use, ultrasonic blade (36) may be positioned in direct
contact with tissue, with or without assistive clamping force
provided by clamp arm (38), to impart ultrasonic vibrational energy
to the tissue and thereby cut and/or seal the tissue. For example,
blade (36) may cut through tissue clamped between clamp arm (38)
and a first treatment side of blade (36), or blade (36) may cut
through tissue positioned in contact with an oppositely disposed
second treatment side of blade (36), for example during a
"back-cutting" movement. In some variations, waveguide (50) may
amplify the ultrasonic vibrations delivered to blade (36). Further,
waveguide (50) may include various features operable to control the
gain of the vibrations, and/or features suitable to tune waveguide
(50) to a selected resonant frequency. Additional exemplary
features of ultrasonic blade (36) and waveguide (50) are described
in greater detail below.
[0037] Waveguide (50) is supported within inner tube (48) by a
plurality of nodal support elements (70) positioned along a length
of waveguide (50), as shown in FIGS. 4 and 5. Specifically, nodal
support elements (70) are positioned longitudinally along waveguide
(50) at locations corresponding to acoustic nodes defined by the
resonant ultrasonic vibrations communicated through waveguide (50).
Nodal support elements (70) may provide structural support to
waveguide (50), and acoustic isolation between waveguide (50) and
inner and outer tubes (46, 48) of shaft assembly (20). In exemplary
variations, nodal support elements (70) may comprise o-rings.
Waveguide (50) is supported at its distal-most acoustic node by a
nodal support element in the form of an overmold member (72), shown
in FIG. 5. Waveguide (50) is secured longitudinally and
rotationally within shaft assembly (20) by retaining pin (66),
which passes through a transverse through-bore (74) formed at a
proximally arranged acoustic node of waveguide (50), such as the
proximal-most acoustic node, for example.
[0038] In the present example, a distal tip (76) of ultrasonic
blade (36) is located at a position corresponding to an anti-node
associated with the resonant ultrasonic vibrations communicated
through waveguide (50). Such a configuration enables the acoustic
assembly (100) of instrument (14) to be tuned to a preferred
resonant frequency f.sub.o when ultrasonic blade (36) is not loaded
by tissue. When ultrasonic transducer (34) is energized by
generator (12) to transmit mechanical vibrations through waveguide
(50) to blade (36), distal tip (76) of blade (36) is caused to
oscillate longitudinally in the range of approximately 20 to 120
microns peak-to-peak, for example, and in some instances in the
range of approximately 20 to 50 microns, at a predetermined
vibratory frequency f.sub.o of approximately 50 kHz, for example.
When ultrasonic blade (36) is positioned in contact with tissue,
the ultrasonic oscillation of blade (36) may simultaneously sever
the tissue and denature the proteins in adjacent tissue cells,
thereby providing a coagulative effect with minimal thermal
spread.
[0039] As shown in FIG. 6, distal end (54) of inner tube (48) may
be offset radially outwardly relative to a remaining proximal
portion of inner tube (48). This configuration enables pivot pin
bore (78), which receives clamp arm pivot pin (56), to be spaced
further away from the longitudinal axis of shaft assembly (20) than
if distal end (54) where formed flush with the remaining proximal
portion of inner tube (48). Advantageously, this provides increased
clearance between proximal portions of clamp arm electrode (42) and
blade electrode (44), thereby mitigating risk of undesired
"shorting" between electrodes (42, 44) and their corresponding
active and return electrical paths, for example during back-cutting
when ultrasonic blade (36) flexes toward clamp arm (38) and pivot
pin (56) in response to normal force exerted on blade (36) by
tissue. In other words, when ultrasonic blade (36) is used in a
back-cutting operation, ultrasonic blade (36) may tend to deflect
slightly away from the longitudinal axis of shaft assembly (20),
toward pin (56). By having pivot pin bore (78) spaced further away
from the longitudinal axis than pivot pin bore (78) otherwise would
be in the absence of the radial offset provided by distal end (54)
of the present example, distal end (54) provides additional lateral
clearance between pivot pin (56) and ultrasonic blade (36), thereby
reducing or eliminating the risk of contact between ultrasonic
blade (36) and pivot pin (56) when ultrasonic blade (36) deflects
laterally during back-cutting operations. In addition to preventing
electrical short circuits that would otherwise result from contact
between ultrasonic blade (36) and pivot pin (56) when end effector
(22) is activated to apply RF electrosurgical energy, the
additional clearance prevents mechanical damage that might
otherwise result from contact between ultrasonic blade (36) and
pivot pin (56) when ultrasonic blade (36) is vibrating
ultrasonically.
[0040] II. Exemplary Surgical Systems with Power Cables and Cable
Adapters
[0041] A. Overview of Exemplary Surgical Systems
[0042] FIG. 7 shows an exemplary surgical system (400) similar to
surgical system (10) in that surgical system (400) includes a
generator (402), a surgical instrument (404), and a power cable
(406) configured to operatively couple surgical instrument (404)
with generator (402). Surgical system (400) further includes a
cable adapter (408) configured to couple power cable (406) with an
output port on generator (402), which may also function as an input
port. Surgical instrument (404) may be in the form of surgical
instrument (14), and may incorporate any one or more of the
exemplary supplemental or alternative features described above.
Surgical instrument (404) includes an internally-mounted ultrasonic
transducer (410), which may be in the form of ultrasonic transducer
(34), described above.
[0043] Power cable (406) includes a first cable end (412)
configured to couple with surgical instrument (404), and a second
cable end (414) configured to couple with generator (402) via cable
adapter (408). In the present example, first cable end (412) is
configured to releasably couple to surgical instrument (404), and
second cable end (414) is configured to releasably couple to a
first adapter end (416) of cable adapter (408). A second adapter
end (418) of cable adapter (408) is configured to releasably couple
to a port on generator (402). The releasable couplings described
above may be achieved using any suitable coupling elements known in
the art. By way of example only, such coupling elements may include
threaded elements, dynamic snap-fit elements, static snap-fit
elements, magnetic elements, and/or friction fit elements. In
alternative configurations, any one or more of the releasable
couplings described above may be non-releasable. For example, first
cable end (412) may be non-releasably attached to surgical
instrument (404), and/or second cable end (414) may be
non-releasably attached to first adapter end (416). In other
configurations, any suitable combination of releasable and
non-releasable couplings between surgical instrument (404), power
cable (406), cable adapter (408), and generator (402) may be
provided.
[0044] In the exemplary configuration shown in FIG. 7, first cable
end (412) of power cable (406) couples to a proximal end of handle
assembly (420) of surgical instrument (404), and aligns coaxially
with ultrasonic transducer (410) housed therein. It will be
understood, however, that first cable end (412) may couple to
handle assembly (420) at various other locations, and/or in various
other orientations relative to transducer (410). For example, in
one alternative configuration, first cable end (412) may couple to
a proximal portion of handle assembly (420) at a location offset
from the central axis of ultrasonic transducer (410). In another
alternative configuration, first cable end (412) may couple to a
lower end of a pistol grip (422) of handle assembly (410).
[0045] FIG. 8 shows another exemplary surgical system (500) similar
to surgical systems (10, 400) in that surgical system (500)
includes a generator (502), a surgical instrument (504), and a
power cable (506) configured to operatively couple surgical
instrument (504) with generator (502). Surgical system (500)
further includes a cable adapter (508) configured to couple power
cable (506) with an output port on generator (502), which may also
function as an input port. Surgical instrument (504) is similar to
surgical instrument (404), except that surgical instrument (504)
includes an externally-mounted ultrasonic transducer (510) that
releasably couples to and is supported by a handle assembly (520)
of surgical instrument (504). Power cable (506) may be
substantially similar to power cable (406). Furthermore, generator
(502), surgical instrument (504), power cable (506), and cable
adapter (508) may be configured to couple to one another in various
configurations similar to those described above in connection with
surgical system (400).
[0046] B. Exemplary Filter Circuitry
[0047] FIG. 9 schematically shows another exemplary surgical system
(600) that includes a generator (602), a surgical instrument (604),
and filter circuitry (606). Surgical system (600) may represent any
of surgical systems (10, 400, 500) described above. In that regard,
generator (602) may represent any of generators (12, 402, 502), and
surgical instrument (602) may represent any of surgical instruments
(14, 404, 504), for example.
[0048] Generator (602) is configured to generate and output a
single, combined drive waveform (or "signal") (610) that includes
an ultrasonic drive component and an RF drive component. Filter
circuitry (606) is configured to receive the single drive waveform
(610) and separate its ultrasonic and RF drive components. More
specifically, filter circuitry (606) converts the single drive
waveform (610) into an ultrasonic drive waveform (or "signal")
(612) and a separate RF drive waveform (or "signal") (614).
Ultrasonic drive waveform (612) is configured to drive an
ultrasonic transducer of surgical instrument (602) to produce
ultrasonic energy for cutting and/or sealing tissue; and an RF
drive waveform (614) is configured to energize bipolar RF
electrodes of surgical instrument (602) with electrosurgical
bipolar RF energy for sealing tissue.
[0049] By way of example only, filter circuitry (606) may be
constructed and function in accordance with the teachings of U.S.
Pub. No. 2017/0086910, entitled "Techniques for Circuit Topologies
for Combined Generator," published Mar. 30, 2017, the disclosure of
which is incorporated by reference herein; U.S. Pub. No.
2017/0086908, entitled "Circuit Topologies for Combined Generator,"
published Mar. 30, 2017, the disclosure of which is incorporated by
reference herein; U.S. Pub. No. 2017/0086911, entitled "Circuits
for Supplying Isolated Direct Current (DC) Voltage to Surgical
Instruments," published Mar. 30, 2017, the disclosure of which is
incorporated by reference herein; U.S. Pub. No. 2017/0086909,
entitled "Frequency Agile Generator for a Surgical Instrument,"
published Mar. 30, 2017, the disclosure of which is incorporated by
reference herein; and/or U.S. Pub. No. 2017/0086876, entitled
"Method and Apparatus for Selecting Operations of a Surgical
Instrument Based on User Intention," published Mar. 30, 2017, the
disclosure of which is incorporated by reference herein.
[0050] Ultrasonic and RF drive waveforms (612, 614) may be
delivered to the ultrasonic transducer and bipolar RF electrodes of
surgical instrument (604) simultaneously, such that instrument
(604) may treat tissue with simultaneous application of ultrasonic
energy and electrosurgical bipolar RF energy. The ultrasonic and RF
energies may be applied selectively, and various parameters of the
applied energies may be selectively adjusted, using user input
features provided on generator (602) and/or on surgical instrument
(604), such as energy control buttons (28, 30), for example. In
various examples, surgical system (600) may be configured to
deliver pre-determined levels and/or patterns of ultrasonic and/or
RF energies based on energy application algorithms pre-programmed
into control circuitry of surgical system (600). Such algorithms
may include any one or more of the exemplary algorithms disclosed
in U.S. Pat. No. 8,663,220, entitled "Ultrasonic Surgical
Instruments," issued Mar. 4, 2014, incorporated by reference above;
U.S. Pub. No. 2017/0000541, entitled "Surgical Instrument with User
Adaptable Techniques," published Jan. 5, 2017, incorporated by
reference above; and/or any other patents or patent applications
incorporated by reference herein.
[0051] Filter circuitry (606) may be arranged at a variety of
suitable locations within surgical system (600). FIG. 10 shows a
first exemplary version of surgical system (600) in the form of
surgical system (620), in which filter circuitry (606) is
integrated with an accessory device (608), which may be in the form
of a power cable or a cable adapter, such as power cables (406,
506) or cable adapters (408, 508) described above, for example.
FIG. 11 shows a second exemplary version of surgical system (600)
in the form of surgical system (630), in which filter circuitry
(606) is integrated with generator (602). FIG. 12 shows a third
exemplary version of surgical system (600) in the form of surgical
system (640), in which filter circuitry (606) is integrated with
surgical instrument (604).
[0052] FIG. 13 shows surgical instrument (404) having filter
circuitry (606) arranged therein at various optional locations, in
accordance with the general configuration of surgical system (640)
of FIG. 12. As shown, and by way of example only, filter circuitry
(606) may be arranged within a proximal portion of handle assembly
(420), proximally of internally-mounted ultrasonic transducer
(410). Alternatively, filter circuitry (606) may be arranged within
a lower portion of pistol grip (422) of handle assembly (420).
[0053] FIG. 14 shows surgical instrument (504) having filter
circuitry (606) arranged therein, in accordance with the general
configuration of surgical system (640) of FIG. 12. As shown, and by
way of example only, filter circuitry (606) may be integrated with
externally-mounted ultrasonic transducer (510).
[0054] III. Exemplary Combinations
[0055] The following examples relate to various non-exhaustive ways
in which the teachings herein may be combined or applied. It should
be understood that the following examples are not intended to
restrict the coverage of any claims that may be presented at any
time in this application or in subsequent filings of this
application. No disclaimer is intended. The following examples are
being provided for nothing more than merely illustrative purposes.
It is contemplated that the various teachings herein may be
arranged and applied in numerous other ways. It is also
contemplated that some variations may omit certain features
referred to in the below examples. Therefore, none of the aspects
or features referred to below should be deemed critical unless
otherwise explicitly indicated as such at a later date by the
inventors or by a successor in interest to the inventors. If any
claims are presented in this application or in subsequent filings
related to this application that include additional features beyond
those referred to below, those additional features shall not be
presumed to have been added for any reason relating to
patentability.
Example 1
[0056] A surgical system comprising: (a) a surgical instrument,
comprising: (i) a body, (ii) a shaft extending distally from the
body, (iii) an ultrasonic transducer supported by the body, and
(iv) an end effector arranged at a distal end of the shaft, wherein
the end effector comprises: (A) an ultrasonic blade, wherein the
ultrasonic transducer is operable to drive the ultrasonic blade
with ultrasonic energy, and (B) an RF electrode operable to seal
tissue with RF energy; (b) a generator operatively coupled with the
surgical instrument, wherein the generator is operable to generate
a combined drive signal having an ultrasonic energy component and
an RF energy component; and (c) filter circuitry arranged
externally of the body of the surgical instrument, wherein the
filter circuitry is operable to convert the combined drive signal
to: (i) an ultrasonic drive signal configured to energize the
ultrasonic transducer to drive the ultrasonic blade with ultrasonic
energy, and (ii) an RF drive signal configured to energize the RF
electrode with RF energy sufficient to seal tissue.
Example 2
[0057] The surgical system of Example 1, further comprising (a) a
power cable configured to couple to the surgical instrument; and
(b) a cable adapter configured to couple the power cable with the
generator, wherein the filter circuitry is arranged within one of
the power cable or the cable adapter.
Example 3
[0058] The surgical system of Example 2, wherein the power cable is
configured to releasably couple to the cable adapter.
Example 4
[0059] The surgical system of any Examples 2 through 3, wherein the
filter circuitry is arranged within the cable adapter.
Example 5
[0060] The surgical system of any of Examples 2 through 3, wherein
the filter circuitry is arranged within the power cable.
Example 6
[0061] The surgical system of Example 1, wherein the filter
circuitry is integrated with the generator.
Example 7
[0062] The surgical system of any of the previous Examples, wherein
a distal end of the power cable is configured to releasably couple
with the body.
Example 8
[0063] The surgical system of any of the previous Examples, wherein
a distal end of the power cable is configured to couple with a
proximal end of the body.
Example 9
[0064] The surgical system of any of Examples 7 through 8, wherein
the distal end of the cable is configured to align coaxially with
the ultrasonic transducer when the power cable is coupled with the
body.
Example 10
[0065] The surgical system of any of the previous Examples, wherein
the ultrasonic transducer is housed within an interior of the
body.
Example 11
[0066] The surgical system of any of Examples 1 through 9, wherein
the ultrasonic transducer is supported externally of the body.
Example 12
[0067] The surgical system of any of the previous Examples, wherein
the filter circuitry is integrated with the ultrasonic
transducer.
Example 13
[0068] The surgical system of any of the previous Examples, wherein
the RF electrode is provided by the ultrasonic blade.
Example 14
[0069] The surgical system of any of the previous Examples, wherein
the RF electrode comprises a first RF electrode, wherein the RF
drive signal is configured to energize the first and second RF
electrodes with bipolar RF energy sufficient to seal tissue.
Example 15
[0070] The surgical system of Example 14, wherein the end effector
further comprises a clamp arm, wherein the clamp arm provides the
first RF electrode and the ultrasonic blade provides the second RF
electrode.
Example 16
[0071] A surgical system comprising: (a) a surgical instrument,
comprising: (i) an ultrasonic transducer, (ii) a shaft extending
distally relative to the ultrasonic transducer, and (iii) an end
effector arranged at a distal end of the shaft, wherein the end
effector comprises: (A) an ultrasonic blade, wherein the ultrasonic
transducer is operable to drive the ultrasonic blade with
ultrasonic energy, and (B) an RF electrode operable to seal tissue
with RF energy; (b) a generator operatively coupled with the
surgical instrument, wherein the generator is operable to generate
a combined drive signal having an ultrasonic energy component and
an RF energy component; and (c) an accessory device configured to
operatively couple the generator with the surgical instrument,
wherein the accessory device includes filter circuitry operable to
convert the combined drive signal to: (i) an ultrasonic drive
signal configured to energize the ultrasonic transducer to drive
the ultrasonic blade with ultrasonic energy, and (ii) an RF drive
signal configured to energize the RF electrode with RF energy
sufficient to seal tissue.
Example 17
[0072] The surgical system of Example 16, wherein the accessory
device is arranged externally of the surgical instrument and the
generator.
Example 18
[0073] The surgical system of any of Examples 16 through 17,
wherein the accessory device comprises one of a power cable
configured to couple to the surgical instrument or a cable adapter
configured to couple the power cable to the generator.
Example 19
[0074] A method of delivering energy to a surgical instrument
having an ultrasonic blade and an RF electrode: (a) generating a
combined drive signal with a generator, wherein the combined drive
signal includes an ultrasonic energy component and an RF energy
component; (b) receiving the combined drive signal with an
accessory device that communicates with the generator and with the
surgical instrument, wherein the accessory device includes filter
circuitry; (c) filtering the combined drive signal with the filter
circuitry to produce an ultrasonic drive signal and a separate RF
drive signal; (d) transmitting the ultrasonic drive signal and the
RF drive signal from the accessory device to the surgical
instrument so that: (i) the ultrasonic drive signal energizes an
ultrasonic transducer to drive the ultrasonic blade with ultrasonic
energy, and (ii) the RF drive signal energizes the RF electrode
with RF energy sufficient to seal tissue.
Example 20
[0075] The method of Example 19, wherein the accessory device
comprises at least one of a power cable or a cable adapter.
[0076] IV. Miscellaneous
[0077] It should be understood that any one or more of the
teachings, expressions, embodiments, examples, etc. described
herein may be combined with any one or more of the other teachings,
expressions, embodiments, examples, etc. that are described herein.
The above-described teachings, expressions, embodiments, examples,
etc. should therefore not be viewed in isolation relative to each
other. Various suitable ways in which the teachings herein may be
combined will be readily apparent to those of ordinary skill in the
art in view of the teachings herein. Such modifications and
variations are intended to be included within the scope of the
claims.
[0078] Further, any one or more of the teachings, expressions,
embodiments, examples, etc. described herein may be combined with
any one or more of the teachings, expressions, embodiments,
examples, etc. described in U.S. Pat. App. No. [Atty. Ref.
END8245USNP], entitled "Combination Ultrasonic and Electrosurgical
Instrument Having Electrical Circuits With Shared Return Path,"
filed on even date herewith; U.S. Pat. App. No. [Atty. Ref.
END8245USNP1], entitled "Combination Ultrasonic and Electrosurgical
Instrument Having Slip Ring Electrical Contact Assembly," filed on
even date herewith; U.S. Pat. App. No. [Atty. Ref. END8245USNP2],
entitled "Combination Ultrasonic and Electrosurgical Instrument
Having Electrically Insulating Features," filed on even date
herewith; U.S. Pat. App. No. [Atty. Ref. END8245USNP3], entitled
"Combination Ultrasonic and Electrosurgical Instrument Having
Curved Ultrasonic Blade," filed on even date herewith; U.S. Pat.
App. No. [Atty. Ref. END8245USNP4], entitled "Combination
Ultrasonic and Electrosurgical Instrument Having Clamp Arm
Electrode," filed on even date herewith; U.S. Pat. App. No. [Atty.
Ref. END8245USNP5], entitled "Combination Ultrasonic and
Electrosurgical Instrument Having Ultrasonic Waveguide With Distal
Overmold Member," filed on even date herewith; and/or U.S. Pat.
App. No. [Atty. Ref. END8245USNP7], entitled "Combination
Ultrasonic and Electrosurgical System Having EEPROM and ASIC
Components," filed on even date herewith. The disclosure of each of
these applications is incorporated by reference herein.
[0079] Further, any one or more of the teachings, expressions,
embodiments, examples, etc. described herein may be combined with
any one or more of the teachings, expressions, embodiments,
examples, etc. described in U.S. Pat. App. No. [Atty. Ref.
END8146USNP], entitled "Combination Ultrasonic and Electrosurgical
Instrument with Clamp Arm Position Input and Method for Identifying
Tissue State," filed on even date herewith; U.S. Pat. App. No.
[Atty. Ref. END8146USNP1], entitled "Combination Ultrasonic and
Electrosurgical Instrument with Adjustable Energy Modalities and
Method for Sealing Tissue and Inhibiting Tissue Resection," filed
on even date herewith; U.S. Pat. App. No. [Atty. Ref.
END8146USNP2], entitled "Combination Ultrasonic and Electrosurgical
Instrument with Adjustable Clamp Force and Related Methods," filed
on even date herewith; U.S. Pat. App. No. [Atty. Ref.
END8146USNP3], entitled "Combination Ultrasonic and Electrosurgical
Instrument with Adjustable Energy Modalities and Method for
Limiting Blade Temperature," filed on even date herewith; U.S. Pat.
App. No. [Atty. Ref. END8146USNP4], entitled "Combination
Ultrasonic and Electrosurgical Instrument and Method for Sealing
Tissue with Various Termination Parameters," filed on even date
herewith; and/or U.S. Pat. App. No. [Atty. Ref. END8146USNP5],
entitled "Combination Ultrasonic and Electrosurgical Instrument and
Method for Sealing Tissue in Successive Phases," filed on even date
herewith. The disclosure of each of these applications is
incorporated by reference herein.
[0080] It should be appreciated that any patent, publication, or
other disclosure material, in whole or in part, that is said to be
incorporated by reference herein is incorporated herein only to the
extent that the incorporated material does not conflict with
existing definitions, statements, or other disclosure material set
forth in this disclosure. As such, and to the extent necessary, the
disclosure as explicitly set forth herein supersedes any
conflicting material incorporated herein by reference. Any
material, or portion thereof, that is said to be incorporated by
reference herein, but which conflicts with existing definitions,
statements, or other disclosure material set forth herein will only
be incorporated to the extent that no conflict arises between that
incorporated material and the existing disclosure material.
[0081] Versions of the devices described above may have application
in conventional medical treatments and procedures conducted by a
medical professional, as well as application in robotic-assisted
medical treatments and procedures. By way of example only, various
teachings herein may be readily incorporated into a robotic
surgical system such as the DAVINCI.TM. system by Intuitive
Surgical, Inc., of Sunnyvale, Calif. Similarly, those of ordinary
skill in the art will recognize that various teachings herein may
be readily combined with various teachings of any of the following:
U.S. Pat. No. 5,792,135, entitled "Articulated Surgical Instrument
For Performing Minimally Invasive Surgery With Enhanced Dexterity
and Sensitivity," issued Aug. 11, 1998, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 5,817,084, entitled
"Remote Center Positioning Device with Flexible Drive," issued Oct.
6, 1998, the disclosure of which is incorporated by reference
herein; U.S. Pat. No. 5,878,193, entitled "Automated Endoscope
System for Optimal Positioning," issued Mar. 2, 1999, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 6,231,565, entitled "Robotic Arm DLUS for Performing Surgical
Tasks," issued May 15, 2001, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 6,783,524, entitled
"Robotic Surgical Tool with Ultrasound Cauterizing and Cutting
Instrument," issued Aug. 31, 2004, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 6,364,888, entitled
"Alignment of Master and Slave in a Minimally Invasive Surgical
Apparatus," issued Apr. 2, 2002, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 7,524,320, entitled
"Mechanical Actuator Interface System for Robotic Surgical Tools,"
issued Apr. 28, 2009, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 7,691,098, entitled "Platform Link
Wrist Mechanism," issued Apr. 6, 2010, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 7,806,891, entitled
"Repositioning and Reorientation of Master/Slave Relationship in
Minimally Invasive Telesurgery," issued Oct. 5, 2010, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 8,844,789, entitled "Automated End Effector Component Reloading
System for Use with a Robotic System," issued Sep. 30, 2014, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 8,820,605, entitled "Robotically-Controlled Surgical
Instruments," issued Sep. 2, 2014, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 8,616,431, entitled
"Shiftable Drive Interface for Robotically-Controlled Surgical
Tool," issued Dec. 31, 2013, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 8,573,461, entitled
"Surgical Stapling Instruments with Cam-Driven Staple Deployment
Arrangements," issued Nov. 5, 2013, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 8,602,288, entitled
"Robotically-Controlled Motorized Surgical End Effector System with
Rotary Actuated Closure Systems Having Variable Actuation Speeds,"
issued Dec. 10, 2013, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 9,301,759, entitled
"Robotically-Controlled Surgical Instrument with Selectively
Articulatable End Effector," issued Apr. 5, 2016, the disclosure of
which is incorporated by reference herein; U.S. Pat. No. 8,783,541,
entitled "Robotically-Controlled Surgical End Effector System,"
issued Jul. 22, 2014, the disclosure of which is incorporated by
reference herein; U.S. Pat. No. 8,479,969, entitled "Drive
Interface for Operably Coupling a Manipulatable Surgical Tool to a
Robot," issued Jul. 9, 2013; U.S. Pat. No. 8,800,838, entitled
"Robotically-Controlled Cable-Based Surgical End Effectors," issued
Aug. 12, 2014, the disclosure of which is incorporated by reference
herein; and/or U.S. Pat. No. 8,573,465, entitled
"Robotically-Controlled Surgical End Effector System with Rotary
Actuated Closure Systems," issued Nov. 5, 2013, the disclosure of
which is incorporated by reference herein.
[0082] Versions of the devices described above may be designed to
be disposed of after a single use, or they can be designed to be
used multiple times. Versions may, in either or both cases, be
reconditioned for reuse after at least one use. Reconditioning may
include any combination of the steps of disassembly of the device,
followed by cleaning or replacement of particular pieces, and
subsequent reassembly. In particular, some versions of the device
may be disassembled, and any number of the particular pieces or
parts of the device may be selectively replaced or removed in any
combination. Upon cleaning and/or replacement of particular parts,
some versions of the device may be reassembled for subsequent use
either at a reconditioning facility, or by a user immediately prior
to a procedure. Those skilled in the art will appreciate that
reconditioning of a device may utilize a variety of techniques for
disassembly, cleaning/replacement, and reassembly. Use of such
techniques, and the resulting reconditioned device, are all within
the scope of the present application.
[0083] By way of example only, versions described herein may be
sterilized before and/or after a procedure. In one sterilization
technique, the device is placed in a closed and sealed container,
such as a plastic or TYVEK bag. The container and device may then
be placed in a field of radiation that can penetrate the container,
such as gamma radiation, x-rays, or high-energy electrons. The
radiation may kill bacteria on the device and in the container. The
sterilized device may then be stored in the sterile container for
later use. A device may also be sterilized using any other
technique known in the art, including but not limited to beta or
gamma radiation, ethylene oxide, or steam.
[0084] Having shown and described various embodiments of the
present invention, further adaptations of the methods and systems
described herein may be accomplished by appropriate modifications
by one of ordinary skill in the art without departing from the
scope of the present invention. Several of such potential
modifications have been mentioned, and others will be apparent to
those skilled in the art. For instance, the examples, embodiments,
geometrics, materials, dimensions, ratios, steps, and the like
discussed above are illustrative and are not required. Accordingly,
the scope of the present invention should be considered in terms of
the following claims and is understood not to be limited to the
details of structure and operation shown and described in the
specification and drawings.
* * * * *